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PubMed1990

Influence of different types of non-resorbable suture material on the healing of extraction wounds--a histological study in rats.

The influence of different non-resorbable suture materials on the healing of tooth extraction wounds was examined in 120 adult male albino rats. Nylon gave the best biological results for healing of the mucosa and dental socket. Silk and cotton produced considerable delay of socket healing. Healing was only mildly delayed by polyester suture, with a short moderate inflammatory reaction at the initial stage.

Alveolar Process↗
PubMed2006

Comparison of bone grafting materials in human extraction sockets: clinical, histologic, and histomorphometric evaluations.

PURPOSE: Although there are a number of bone replacement graft materials that are currently available for clinical use, there are few studies that directly compare efficacy among graft treatments before implant placement. The purpose of this report was to compare 3 bone replacement graft materials (PepGen P-15 228 FLOW [DENTSPLY Friadent CeraMed, Lakewood, CO], Puros [Zimmer Dental, Carlsbad, CA], and C-Graft 228 [Clinician's Preference, Golden, CO]) for bone formation by clinical, histologic, and histomorphometric evaluation. MATERIALS AND METHODS: In this prospective, intraoral pilot study, 13 maxillary sockets in 2 patients (both smokers) were grafted immediately after tooth extraction with C-Graft 228, Puros, or PepGen P-15 228 FLOW (containing additional PepGen P-15 228 particles; FLOW PUTTY). After 4 months, bone cores were retrieved and analyzed histologically. RESULTS: PepGen P-15 228 FLOW PUTTY produced a significantly (P <0.01) higher amount of vital bone than C-Graft 228 or Puros. The amount of vital bone for FLOW PUTTY was 12-fold higher than for C-Graft 228 and 4-fold higher than Puros. Of 7 FLOW PUTTY treated sites, 7 showed >14% vital bone versus 0 of 3 C-Graft 228 and 0 of 3 Puros treated sites. FLOW PUTTY treated sites showed new vital bone between particles of residual graft. C-Graft 228 treated sites showed residual particles in a background of connective tissue with very little bone. Puros treated sites showed nonvital bone particles in a background of connective tissue, with some new vital bone forming around the nonvital bone. CONCLUSION: PepGen P-15 228 FLOW PUTTY produced significantly greater vital bone as compared to Puros and C-Graft 228 after 4 months. A larger clinical study is required to confirm these results.

Adult↗
PubMed1992

Inferior alveolar nerve reconstruction with a polyglycolic acid bioabsorbable nerve conduit.

A custom-designed polyglycolic acid (PGA) bioabsorbable nerve conduit was used to reconstruct a 25-mm defect in the right inferior alveolar nerve. The initial nerve injury, following a dental extraction, resulted in loss of lower lip sensation and severe facial pain. Sixteen months after tooth extraction, with no improvement in symptomatology, the alveolar canal was enlarged in diameter by means of mandibular osteotomy to accommodate a 2-mm-diameter polyglycolic acid tube. The proximal end of the inferior alveolar nerve was sutured into the polyglycolic acid tube. The mental nerve was sutured into the distal end of the tube. Pain of neural origin was relieved in the early postoperative period. Two years following nerve reconstruction, pain relief remains excellent and perception of pressure and vibration is similar to the thresholds for these perceptions on the contralateral lip.

Absorption↗
PubMed1997

Placement of implants into fresh extraction sites: 4 to 7 years retrospective evaluation of 95 immediate implants.

A 7-year follow-up of implants placed immediately after tooth extraction into fresh extraction sites is reported. Small autogenous bone chips (from bone adjacent to implant sites) were grafted into the defect between the implant and the socket walls when needed. Closure of the wound was obtained by coronal repositioning of the flap, and no membranes were used. Care was taken to minimize hematoma formation under the flap during healing by part-time use of removable prosthesis with thick soft linings after implant surgery. At second stage surgery, mucoperiosteal flaps were apically repositioned for maximum attached gingival width and to reconstruct the vestibule. Minor complications such as exposure occurred in 16% of cases. Implant mean 5-year cumulative survival rate was 95%. There was no implant loss after loading. The results indicated that implants placed into fresh extraction sites grafted with autogenous bone chips will heal predictably.

Adult↗
PubMed1998

Immediate implant placement: a procedure without incisions.

Primary socket closure in immediate implantation may be difficult, due to the opening left by the extracted tooth. The absolute need for bone augmentation and primary flap closure for implants placed into fresh extraction sites has never been proven. The hypothesis of the present study was that immediate implants can succeed without primary flap closure. A technique that does not require any incisions during immediate implant placement is described. No barrier membranes were used and the sole grafting material used were autogenous bone chips. Full soft tissue coverage was achieved 1 week to 2 months postimplantation. Clinical osseointegration was achieved with minimal gingival recession and papillae preservation. Immediate implant placement in the anterior maxilla can be successful for replacing a single tooth even without primary closure.

Adult↗
PubMed2000

Evaluation of recombinant human bone morphogenetic protein-2 in oral applications including the use of endosseous implants: 3-year results of a pilot study in humans.

BACKGROUND: This study evaluated patients who had been treated with recombinant human bone morphogenetic protein-2 (rhBMP-2) loaded in an absorbable collagen sponge (ACS) in human extraction sites or in sites that required alveolar ridge augmentation. An earlier report on the same patients revealed that after 4 months, implantation of rhBMP-2/ACS was safe, as determined by clinical, radiographic, systemic, and immunological analyses. In this longer-term follow-up, eligible patients were restored with endosseous dental implants in the area treated with rhBMP-2/ACS and bone biopsy samples were taken for histological analysis of the treated human bone tissue. The primary objective was to monitor the long-term safety of patients treated with rhBMP-2/ACS. Another objective was to evaluate the dental implants placed in the sites treated with rhBMP-2. METHODS: Patient safety was evaluated by clinical examinations, periapical radiographs, and occurrence of adverse experiences. Dental implants were evaluated by radiographic and clinical examination. All 12 patients have been followed for 3 years. RESULTS: Two years following surgical implantation of rhBMP-2/ACS, no serious or unexpected adverse experiences occurred. The adverse experiences that did occur were mostly benign and compatible with the dental implant surgeries performed in these patients. No adverse experiences were deemed as related to the rhBMP-2/ACS. Furthermore, no safety concerns in the local area of rhBMP-2/ACS placement were noted, based on oral wound examinations. In the 10 patients (6 extraction socket patients and 4 augmentation patients) who received endosseous implants, all implants were clinically stable at all assessments and all 10 patients have been functionally restored. Histological evaluation of the human bone core biopsies revealed normal bone tissue formation identical to the surrounding native bone. Three-year follow-up clinical examinations revealed that all implants had stable marginal bone levels and healthy peri-implant tissues. CONCLUSIONS: These 3-year results demonstrate that rhBMP-2/ACS can be used safely in human patients. Human bone biopsies reveal normal bone formation in areas treated with rhBMP-2/ACS. Endosseous implants placed in these areas were all stable with no radiographic or clinical complications. The results from this study suggest that rhBMP-2/ACS (0.43 mg/ml) can be safely used in tooth extraction sites and in local ridge augmentation procedures and that endosseous dental implants placed in bony areas treated with rhBMP-2/ACS are stable and can be functionally restored without complication.

Alveolar Process↗
PubMed1989

[Two case reports of extraction with the upper central incisors].

Although extraction of the upper central incisors is very rare because of their esthetical importance, they are sometimes extracted when impaction, root resorption, abnormal morphology, severe caries and/or trauma are involved. When extracted, tooth size adjustment, crown-bridge and/or orthodontic treatment are proposed for functional and/or esthetic improvement. Two present cases were reported of Angle class I crowding with root resorption of the upper central incisors caused by apical abscess (case 1) and impacted canines (case 2). The above central incisors were extracted and orthodontic tooth alignment was performed on both cases prior to final occlusal adjustment. Problems we encountered in through these cases were tooth size ratio between the upper and lower teeth causing spacing arch and/or disharmony of occlusion. In case 1, edge to edge anterior relationship was established because the over-all tooth ratio was 93.30% which was out side one standard deviation although the upper lateral incisors were tipped mesially to create some spaces. The over-all tooth ratio in case 2, however, was 92.13% which was inside one standard deviation and normal occlusion was restored. It is suggested that final tooth size adjustment is necessary for good occlusion in extraction cases of upper central incisors.

Adolescent↗
PubMed1992

Short term bone healing in calcium deficiency osteopenia and disuse osteopenia: experimental studies in adult rats.

Adult male Sprague-Dawley rats (average weight 530-540 g) were studied in two different series. In series I, studying disuse osteopenia, the experimental rats had all maxillary molars extracted on one side. After 16 wk they had their mandibular first molar of the corresponding side extracted and were followed for another 4 wk. In series II, studying calcium deficiency osteopenia, the experimental rats were given a low calcium diet for 16 wk and at this time had their mandibular first molars extracted. Both disuse and calcium deficiency caused osteopenia, which did not seem to impair the healing process after tooth extraction in the short term. One puzzling finding in the disuse series (I) was that the alveolar height at the extraction site was higher in the experimental than in the control group 4 wk after extraction.

Alveolar Process↗
PubMed1993

The reinnervation of healing extraction sockets in the ferret.

The objective of this study was to describe the pattern of healing of pulpal and periodontal nerve fibers following tooth extraction. The mandibular canine teeth were, under general anesthesia, removed from one side of nine young ferrets. One week (two animals), one month (four animals), and three months (three animals) later, again under general anesthesia, the animals were perfused with fixative. The mandibles were decalcified, paraffin-embedded, and serially sectioned. Sample sections were stained with hematoxylin and eosin, the remainder with a silver stain for nerves. Serial reconstructions were made of the innervation in control teeth and in the extraction sockets. A grid sampling technique was used for the estimation of the innervation density in different regions at various levels in the healing socket. One week after extraction, although osteoid material was beginning to fill the socket, the pattern of innervation remained similar to that of controls in being restricted to the former location of the periodontal ligament and being densest in the apical third of the socket. One month after extraction, the innervation consisted of many fine axons or small bundles distributed throughout the healing osteoid tissue though still most dense in the periphery of the socket. The overall innervation density increased between one week and one month post-extraction. At three months, as the margins of the socket were becoming obscured, the innervation consisted largely of one or two organized nerve trunks running from the apical to the coronal aspect in either the central or lateral aspects of the socket. At no time was there evidence of neuroma formation.

Alveolar Process↗
PubMed1986

Alveolar wound healing after x-irradiation: a histologic, radiographic, and histometric study.

Healing of extraction wounds in rats following cephalic irradiation was studied by histologic, radiographic, and histometric methods 14 days after tooth extraction. Irradiation was given at 0, 3, and 7 days after surgery in doses of either 15, 20, or 30 Gy. No significant differences were seen with the different doses given seven days post-extraction. However, socket healing was delayed when irradiation was given immediately and three days after extraction. On the basis of these observations, it is recommended that radiation not begin until at least one week after the extraction of teeth.

Alveolar Process↗
PubMed2004

Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.

The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthodontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary.

Adult↗
PubMed1987

Periodontal conditions of teeth adjacent to extraction sites.

The purpose of the present clinical study was to evaluate the effect of tooth extractions on the periodontal conditions of adjacent teeth. 40 patients were selected for the study. Prior to the extractions, baseline data of the adjacent teeth were obtained. Plaque (PII) and gingival indices (GI), pocket probing depths and probing attachment levels were scored. In addition, the alveolar bone height was determined radiographically in relation to the CEJ adjacent to the extraction sites. The contralateral side of the jaw, where no tooth had to be removed, was examined as a control. A limited hygienic phase (scaling and root planing of all surfaces examined) was performed immediately prior to the extractions. Using the same parameters, all sites were reexamined 2-4 months and 6-9 months following the extractions. After the hygienic phase, the teeth adjacent to the extraction sites indicated a decrease in the pocket probing depths by 0.5 to 1.5 mm. In shallow pockets (1-3 mm), this decrease was less pronounced than in moderate to deep pockets (4-9 mm), where it was composed of shrinkage of the gingival tissues and gain of probing attachment. The radiographic level of the bony alveolar crest in relation to the CEJ of the adjacent teeth was not altered by the extraction procedure. The oral hygiene performances of the patients were not influenced during the 9-month observation period. Therefore, neither PII nor GI scores showed relevant improvements.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Plaque Index↗
PubMed1995

Ridge augmentation for immediate postextraction implants: eight year retrospective study.

Implant placement immediately after tooth extraction has become a well accepted treatment modality. It is used to replace either a single tooth or several teeth in an edentulous ridge. Various augmentation materials are used to build up the edentulous ridge, to maintain it, and to prevent resorption upon extraction. The learning objective of this paper is to present an 8-year retrospective study of 55 screw-type implant placement in 40 patients, using an alloplast (mixed with autogenous blood) as the augmentation material. The paper reviews the progress of implant technology and describes the method and materials used in this particular study. Four cases are used to illustrate the simultaneous implantation and ridge augmentation procedure.

Adult↗
PubMed2006

The application of bone graft substitutes for alveolar ridge preservation after orthodontic extractions and for augmentation of residual cleft defects.

The use of bone substitute materials in orthodontics is to be considered prior to orthodontic space closure after tooth extraction during the treatment of marked crowding as well as for treatment of residual defects in cleft-lip-and-palate children. In both cases the common objective is structure preservation or augmentation of the alveolar ridge. The demands to be made on the synthetic bone graft substitute comprise not just complication-free and safe use but also the chance of early tooth movement into the treated defect area with sufficient stability of the new tooth position.

Alveolar Ridge Augmentation↗
PubMed1977

Role of health education among services rendered by dental personnel in Finland.

The quantity and origins of dental health education information were surveyed in June 1973 by interviews with a sample comprising 505 persons drawn to cover the total Finnish population aged 15 years and over. The interview revealed that tooth extraction was the most frequent (43%) of the measures performed during the last visit to dentist and tooth filling was the measure second in frequency (41%). Rare measures were periodontal treatment (13%) and teaching of home care (2%). Radio and television were the most frequently mentioned sources of information (47%); however, the evaluations of the reliability of information on dental health education in the mass media were skeptical. Dental service personnel was a not minor source of information (33%) and its effectiveness was recognized. Although dental health education performed on the personal level is a great challenge, which should be accepted by the whole dental personnel, a total of 58% of the interviewees were of the opinion that they had not received sufficient information on dental home care.

Adolescent↗
PubMed1990

Primary herpes simplex virus (type 1) infection delays healing of oral excisional and extraction wounds in the rat.

The effect of acute herpes simplex virus type 1 (HSV-1) infection on the healing process of intraoral wounds and tooth extraction sockets in the rat was studied. A standardized size of the buccal mucosa was excised and molars were extracted and a HSV-1 suspension was topically applied. The virus infected wounds were clinically characterized by erythema and swelling and histologically by heavy inflammation cell infiltrate and abscesses during the first week. The acute HSV-1 infection was found to significantly delay healing of both types of wounds by 3 days. Antiviral treatment with acyclovir (ACV) decreased the degree of inflammation and improved healing of the infected wounds. The present results indicate a delayed and disturbed healing of wounds in the oral cavity in the presence of HSV-1. The findings may have a clinical significance for primary or latent HSV-1 infections in conjunction with surgical intervention in the oral cavity.

Acyclovir↗
PubMedDate not supplied

Dental bacteremia in children.

Bacteremia resulting from dental extraction is regarded as an important cause of bacterial endocarditis, and it is therefore recommended that patients undergoing tooth extraction be given prophylactic antibiotics. As dental procedures other than extractions may also cause bacteremias, we studied a variety of dental procedures routinely used in pediatric dentistry. Blood samples for cultures were obtained 30 s after each of 13 dental operative procedures in 735 anesthetized children aged 2-16 years. Four procedures used for conservative dentistry caused bacteremias significantly more often than the baseline value of 9.4%: polishing teeth 24.5%, intraligamental injection 96.6%, rubber dam placement 29.4%, and matrix band with wedge placement 32.1%. In comparison, toothbrushing alone caused a bacteremia on 38.5% of occasions. The organisms isolated were typical of odontogenic bacteremias in that 50% of the isolates were identified as varieties of viridans streptococci. These data show that a wider variety of dental procedures than was previously documented cause bacteremia.

Adolescent↗
PubMed2001

Hydrogen peroxide and superoxide anion production by polymorphonuclear neutrophils in patients with chronic periapical granuloma, before and after surgical treatment.

Chronic periapical granuloma represents a localized tissue injury with well established signs of systemic immunological reactions. The aim of the study was to investigate changes in superoxide anion and hydrogen peroxide production by polymorphonuclear neutrophils (PMN) in patients with chronic periapical granuloma before and after surgical treatment. The affected teeth were extracted from 20 patients with chronic periapical lesions. Blood samples were obtained at admission, before extraction and on day 14. PMNs were isolated from blood samples and superoxide anion (O2-) and hydrogen peroxide (H2O2) production were estimated without stimulation and after stimulation of the cells with opsonized zymosan. Similar procedures were performed with blood samples obtained from 20 healthy controls. Superoxide anions as well as hydrogen peroxide production by unstimulated cells obtained from patients before treatment were significantly higher in comparison with controls. Fourteen days after extraction O2- production by unstimulated cells was higher than the controls and significantly lower in comparison to PMNs obtained before treatment, while H2O2 production was not significantly higher when compared to controls and significantly lower in comparison with PMNs obtained before extraction. The results obtained strongly imply the termination of a generalized inflammatory response after elimination of local inflammation by tooth extraction.

Adult↗